Abstract

Background

Acute flaccid paralysis surveillance (AFP) is an essential strategy of the WHO’s Polio
Eradication Initiative. This is the first study conducted to estimate the incidence,
etiology, distribution, and surveillance performance of AFP in Iraq.

Methods

Surveillance data about the AFP cases under the age of 15 years reported from Iraq
during January 1997 to December 2011 were depended in the current study.

Results

A total of 4974 cases of AFP were reported from Iraq during the study period, with
an annual incidence of 2.5/100,000 population. Guillain-Barré syndrome represented
more than half of the reported cases (N = 2611, 52.5%), followed by traumatic neuritis
(N = 715, 14.4%), and other CNS infections (N = 292, 5.9%). Poliomyelitis accounted
for 166 (3.3%) of cases, the last reported case being in January 2000. Surveillance
performance showed that all, but two, indicators were below the required WHO recommended
levels.

Conclusions

AFP surveillance remains the gold standard method for poliomyelitis detection. It
witnessed dramatic changes over the last two decades. This has raised people’s and
clinicians’ awareness to the importance of promptness in notifying suspected cases
and timely transportation of stool specimens to the National Poliovirus Laboratory
in Baghdad, or alternatively having more than one laboratory for poliovirus detection
in the country, all of which are very useful measures to increase the surveillance
performance in the country.